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Sensory Integration Information Links

To find sensory integration practice in your area, look in your online yellow pages for occupational therapy, find the ones who work with children, and then call and find out if they use sensory integration theory in their practice. Have them explain a little of what they do, since that can mean totally different things to different people. To study up a little on the terminology, look at Sensory 101WPS used to maintain a list of therapists who completed SIPT training through them, but I can't find it now. OTs who have completed this program are known as "Certified in Sensory Integration," and "SIPT certified," because part of the training is in the administration and interpretation of the Sensory Integration and Praxis Test or SIPT.  Not every therapist who has completed this certification is listed, however. And many therapists who are very active in using sensory integration therapy have not completed this certification.

In the Richmond, Virginia area I have had experience with the sensory integration practices at Geri Allen's Integrated Therapy Services (Geri Allen passed away, sadly, and this clinic is closed). Therapists from Integrated Therapy Services have started two different clinics, Spot On Therapy and Tree House Pediatric Therapy. Between them they currently have at least three OT's who are SIPT-certified working there.  I know there are other local practices that do some amount of SI therapy, but those are the two big ones that I know of near me.  When I lived in California, I worked for Fourt Therapy Center (now Play Steps, as Barbara partiall retired) and can very highly recommend them. I learned a LOT from Barbara Fourt. There are several other well-reputed clinics in that area who work with children with sensory integration difficulties.

Sensory Integration International (SII), aka The Ayres Clinic, is now kaput. There is no central "ownership" of Sensory Integration, and things seem to be going through a new organization of sorts. Stay tuned.

The Sensory Processing Disorder Foundation
is a project of the nonprofit organization KID Foundation in Littleton, Colorado. It is designed to serve as a resource to parents of children with sensory processing difficulties, which they term "sensory processing disorder (SPD)." There is a Parent Connection, a Resource Directory, and articles on sensory integration and processing.

The SI Network is in UK/Ireland.

The Alert Program is a program that was designed by two occupational therapists for OTs, teachers, and parents to use in working with children. It can be adapted to use with children of a wide age range, but is ideally suited for children who function at about a typical seven to thirteen-year old level, in my experience. The program, outlined in the guidebook How Does Your Engine Run? uses the analogy of a car engine to explore the concepts of levels of alertness and how each person can use sensory strategies to change their own levels for different tasks.  I often loan the Introductory Booklet (the first chapter of the guide book; can be purchased separately) to parents and teachers as a great explanation of one way of looking at sensory processing and how it can affect children's daily lives. There is also a book of activities that incorporate sensory strategies, mostly for Kindergarten through second grade classrooms, called Take Five.

The Zones of Regulation program takes some of the Alert Program approaches, and adds in some concepts from Social Thinking and from The Incredible 5 Point Scale. So it adds in Executive Function/ cognitive therapy ideas as well as emotional regulation ideas to the sensory processing ideas. I have been using it over the last couple of years and I like it especially with the very concrete children who reject an engine concept.

Professional Development Programs sponsors what they term "cutting edge" courses in the area of sensory integration. I have attended several. Anything that is "cutting edge" is by definition not yet well-researched and well-established, right? In other words, I would advise you to take what you learn at these courses with a grain of salt. I do think that they share some information that is very useful at many of the courses, but at one I attended several years ago they were still touting that autism is linked to vaccines and has to do with heavy metal build-up in the body. I find this irresponsible and dangerous ground and do not feel comfortable with occupational therapists who advise on treatments to move heavy metals about in children's bodies. 

I have also attended courses that taught how to use Therapeutic Listening® from Vital Links. This is a program which uses Vital Links' own proprietary compact discs of music as well as cd's from other sources for "therapeutic use of sound."  I have helped set up families to use this program, and again I would say to take it with a grain of salt, but I believe that music can have some very dramatic effects on children ~ if nothing else, it can be very focusing! There are a bunch of other listening therapies, but I haven't done any training or reading up on them. These don't get used much in school-based OT.

Here is a link to the website of an OT who uses many modalities in her treatment and has written several books. She bases all of her "information" on her own experiences in treatment, and seems to sort of disdain actual research, but I like her accessible and seemingly sensible discussions of sensory processing topics, and I haven't found information that I entirely disagree with (so much grey area!).

Sensory Evaluation Tools

Sensory processing is not something that can be directly measured, since it is a purely subjective area. We cannot see how things appear to another person, or hear how different noises sound. Children often lack the vocabulary and the point of reference to describe how they are experiencing the world. Therefore, we are limited to observing responses to different sensations and looking for evidence of difficulty making good use of sensory input. For example, if a child has a hard time standing on one foot, we can theorize that they may not be integrating their sense of gravity's pull, or of their awareness of their own position in space, or both. We can then further investigate similar areas through other observed activities and assemble a picture of ability and difficulty, "detective-style." There are very few standardized or normative tests that assess sensory integration or processing:

The Sensory Integration and Praxis Test (SIPT)
is a standardized battery of tests to get an in-depth look at various aspects of sensory processing in order to assess sensory integration dysfunction. It can be used on children four 8 years, 11 months of age. It takes several hours to administer the whole test and requires extensive and expensive training to learn to administer it. Therapists who complete this training (through Western Psychological Services) are certified and listed in a database. Because of the commitment required to become certified, it can be difficult to find a therapist in your area who is trained to administer this test. Some therapists use subtests from this tool (or from its precursor, the Southern California Test of Sensory Integration) as informal tools to look at specific aspects of sensory processing such as motor planning or bilateral integration in motor skills.

The Sensory Profile is a standardized tool for measuring sensory abilities and the effect those abilities have on functional performance in children three to ten.  It is a judgment-based questionnaire that evaluates how a child responds to visual, auditory, touch, taste, movement, and multi sensory stimuli. A classification system based on means is used to rate the child’s responses in comparison to a normative sample of children. It is helpful in determining whether there is a strong pattern of over- or under-responsiveness to sensory input in general, as well as in which areas those atypical responses are most often seen. There is also a School Companion Sensory Profile which is usually given to teachers; it doesn't include a lot of the questions that would be seen at home but not at school ("exhibits distress during grooming," for example).  Now there is also an Adult/Adolescent Sensory Profile, which I sometimes use interview-style with young teens or pre-teens to assess their awareness and perception of their own sensory preferences, as well as an Infant/Toddler Sensory Profile.

Many therapists prefer theSensory Processing Measure. This comes with various questionnaires for different environments, from classroom to PE class to the bus. They are meant to be used to compare and contrast to do the detective work of sensory assessment.

TheTest of Sensory Functions in Infants was developed by early childhood specialists Georgia DeGangi, PhD, OTR and Dr. Stanley Greenspan, (well known for his approach in working with children called DIR, commonly often called "floor time").  It assesses five areas of sensory function (reactivity to tactile deep pressure, adaptive motor functions, visual-tactile integration, ocular-motor control, and reactivity to vestibular stimulation) in children from four to eighteen months of age. Each item is scored via a numerical rating scale and results in "normal," "at risk," or "deficient" scores (an older test with not-so sensitive terms).

In addition, therapists often use standardized motor skills tests such as the Peabody Developmental Motor Scales, 2nd ed. (PDMS-2), for children birth to six years of age, or the Bruininks-Oseretsky Test of Motor Performance (TMP-2). I have used the M-FUN by Lucy Jane Miller (ages 2-8 roughly).

Often, therapists will use informal assessment methods to investigate sensory processing and integration. These can include structured observations, such as asking a child to try to imitate positions, hand placements, or gestures without looking at their own body. Or watching a child navigate an unfamiliar obstacle course while noting how quickly and adeptly he is able to move himself under/over/through the equipment. Both of these observations would assess motor planning, and both would require familiarity with typical development of motor skills for comparison. As a guide to assessing sensory integration through observation, A. Jean Ayres published a form called "Clinical Observation of Sensory Integration" in 1975. It includes such observations as eye movements across body midline, holding of trunk flexion and extension against gravity, and the presence or absence of tonic neck reflexes.  More recently, Winnie Dunn, M.Ed., OTR incorporated some of these observations and used a normative population of 263 children to come up with some broad guidelines for Kindergarten-aged children, published as A Guide to Testing Clinical Observations in Kindergarteners. Pretty sure all such things are out of print, but still useful if you've got a copy!

Other observations could include directly observing responses to typically non-aversive sensations. For example, if a child covers her ears when the bathroom fan goes on, comments on the ticking of a quiet clock, seems afraid of a fuzzy stuffed animal, or strongly avoids letting his feet come off the ground while sitting on a swing, a therapist would note that and look for patterns.

Last but not least, an interview with caregivers and/or teachers about their observations, concerns, and reports of typical behaviors and abilities can be an important piece of the puzzle. No one knows a child better than the people who spend every day with her. This is usually where I start my whole assessment process, not an afterthought. Asking the right questions and just listening can save a therapist lots of time as she gathers information and helps with the detective work of assessing sensory processing.


(see below for books specific to oral motor work)

Speaking of books, I LOVE Oh Behave! and recommend it to teachers all the time. It is a booklet that summarizes/reviews the basics of behavioral management in a classroom (or with your own children) and then talks about when and how you can tell if behavior is due to sensory issues or not.  There are guides and worksheets for the "detective work" of identifying the triggers and reasons for a particular behavior and then assistance to what to do about it once you've figured it out. It answers questions like, "how do I offer sensory strategies without rewarding the negative behavior." Unfortunately, this booklet only comes in packs of 10 (for about $45 per pack).  You may find, as I do, that you can easily find 9 other people who you think could benefit from it!  It is only available at Pearson Assessments/PsychCorp (along with lots of other interesting sounding books that I haven't read).

Sensory Integration and the Child by A. Jean Ayres. This is the classic explanation of SI for the layperson by the mama of sensory integration herself. Clearly written. Doesn't offer any do-it-yourself strategies to speak of, it aims at explaining clinic-based SI therapy.
Link to book at

book coverThe Out of Sync Child by Carol Kranowitz is a popular-press book that introduces sensory integration and sensory processing disorder to the lay person. It is an easy read that uses lots of "case studies" as examples of what sensory processing disorder can look like. It does tend to use somewhat extreme examples and presents things in black and white rather than getting into the complex interplay of sensory processing, mood, personality, other reasons for behavior,  family dynamics etc. etc. The follow-up book, ThRaising A
                    Sensory Smart Childe Out of Sync Child Has Fun, is full of activities for children with sensory processing problems. Available in many bookstores and at amazon.

I actually like Raising A Sensory Smart Child, by an O.T. and a mother of a child with SPD, better than The Out of Sync Child. It does more to explain each of the sensory systems and how therapists might work on them. It also has lots of practical methods for dealing with picky eaters, behavior, speech problems, sensory sensitivites to clothing, advocating for sensory needs in school, organization problems, etc. etc. Here also is the author's nifty website:

Too Loud, Too Bright, Too Fast, Too Tight: What to Do If You Are Sensory Defensive in an Overstimulating World
by Sharon Heller. A book by a college professor about her own experiences with difficulties modulating responses to sensory stimuli. I haven't read this one myself yet, but it looks interesting!

There are a few other books and some videos, including a video of The Out of Sync Child (apparently not available on DVD), but I haven't watched any of them myself.  Try some of the catalogs listed below or the links above. I have read Sensory Secrets: How to Jump-Start Learning in Children by Catherine Schneider. I didn't feel that it added anything not already found in the above books, and went beyond what is actually pretty well-established theory in the field, so I can't recommend it.

This book - Understanding Your Child's Sensory Signals and another by the same OT is highly recommended on Amazon. The author's website is (also linked above).
            Your Childs SPD

And, there is this authoritative textbook: Sensory Integration Theory & Practice edited by Bundy, Lane, and Murray. Got it, peruse it often, love it.

Sources for Sensory Materials and Tools

Southpaw catalog has lots of large items for use in making up a sensory gym (clinic-based OTs often order from them), as well as many smaller items for home use.

Integrations and Abilitationsare two catalogs under the School Specialty family of catalogs that are have many items for sensory needs. They have fantastic pieces of furniture and items to set up a sensory room. This stuff is expensive but it is soooo cool. I have gotten to visit a sensory area that was set up using these items at a school for special needs children in Toronto. It definitely makes you want to stay for a while and play!  Two items: 1) in the interest of full disclosure, Abilitations sells an item that I invented and that I get royalties from. 2) the online catalogs from this company are kind of awkward to use. For example the search engines are pretty poor at finding things unless you have the exact title, and it's kind of hard to navigate through to just what you want. The paper catalogs are much more fun and easy to look at, though of course they eat up trees!

Fun and Function is a newer seller of similar items, with less selection but sometimes cheaper. I can't speak for their products, haven't seen many in person. I don't like that they give misinformation in their blog (recently noticed that they touted putting weighted items on low-tone children to normalize their tone. Um.... no.)

Acheivement Products is another source of neat things.

For oral motor and oral desensitization tools, Professional Development Programs is the place!  Their catalog has ZILLIONS of oral motor tools (whistles, straws, vibrating things, more than you could imagine!) as well as various tactile sensory tools.
Besides sponsoring courses (see above), they have published an oral issues book for therapists who are addressing mouth issues as part of a therapy program (and now a DVD of the course) called M.O.R.E.: Integrating the Mouth With Sensory and Postural Functions

Some kids just need to chew for a period. These are the kids with wet sleeves, neck ribbings and hoodie strings, or mangled pencils. I knew a 1st grader who "ate" several wooden rulers before his teacher figured out where they had gone. Working on finding more appropriate sensory outlets/inputs for those kids is important, but part of that may be better things to chew. PDP, above, has some of these as does Abilitations, above.     I like best the ones that look like a normal piece of jewelry 

a pen lanyard

or just a tube on a pencil -- a piece of medical tubing cut and stuck over the eraser end.

book coverAlso, there is a book called Just Take A Bite:  Easy, Effective Answers to Food Aversions and Eating Challenges by Lori Ernsperger, Ph.D. and Tania Stegen-Hanson, OTR/L,(Foreword by Temple Grandin ). It purports to have non-confrontational methods to work with kids who are picky eaters for whatever reason! Available at Amazon.

seat cushion

Movin'sit cushions (scroll down my list) -- these are inflatable wedge-shaped seat cushions that allow the child who can't sit still to stay in his seat while getting the movement he craves. Also promotes good seated posture. Comes in 2 sizes.  Similar but round cushions are called Disc o'Sits.

Soft Clothing has socks and clothes for people with issues of sensitivity to such things.

fidget toysFidget toys are little items of any description that keep hands busy so that kids can stay in their seats, wait their turns, keep from blurting out, and listen for longer than usual. Different fidget items work for different children; some can't have anything in their hands without it commanding their full attention (or becoming a projectile), while other children can be completing a complex puzzle while actually listening to everything that is being said. It's best to experiment with a variety of objects of different tactile qualities and levels of complexity, and you WILL need to teach the difference between a fidget item and a toy. My approach is to ask for 15 minutes and teach the whole class about fidgets, the rules of fidgets, what "interesting" means and that toys are interesting for your eyes and brain, while fidgets are not. I tell children, "if it's really fun, then it isn't a good fidget for you!" Then I leave a basket for the whole class to try out for a week or 2. In this way I teach the teacher at the same time as the students, and after a week or so when the novelty wears off, only the students who need the fidgets will still be using them. And the teacher can make observations about which ones work best for the target student(s). has a wide assortment. You can also check out Office Playground for a wide variety, but not designed for kids necessarily. Be warned they will send weekly emails if you purchase from them.

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